Anatomy Atlases: Atlas of Human Anatomy in Cross Section: Section 3. Middle Thorax (Heart and Lungs)

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Atlas of Human Anatomy in Cross Section: Section 3. Middle Thorax (Heart and Lungs)

Plate 3.5

Ronald A. Bergman, Ph.D., Adel K. Afifi, M.D., Jean J. Jew, M.D., and Paul C. Reimann, B.S.
Peer Review Status: Externally Peer Reviewed

Upper Left Quadrant	Lower Left Quadrant	Lower Right Quadrant	Upper Right Quadrant
1. Costomediastinal recess 2. Right coronary a. and v. in coronary sulcus 3. Costosternal articulation, synovial joint 4. Internal thoracic a. and v. 5. Pleural cavity 6. Rib 4 7. Pectoralis major m. 8. Right atrium 9. Pectoralis minor m 10. Septum membranaceum (atrioventricular part) 11. Ribs 12. Phrenic nerve 13. Lung, right upper lobe, anterior segment 14. Superior vena cava 15. Foramen ovale 16. Rib 6 17. Pericardium and left atrium 18. Pulmonary v., right inflow tract	19. Intercostal neurovascular bundle 20. Lung, right lower lobe, superior segment 21. Long thoracic nerve and lateral thoracic a. and v. 22. Rib 7 23. Thoracodorsal nerve and thoracodorsal a. and v. 24. Latissimus dorsi m. 25. Intercostal neurovascular bundle in costal groove 26. Right vagus and esophageal plexus 27. Esophagus 28. Esophageal blood vessels 29. Greater splanchnic nerve, azygos v., and thoracic duct 30. Intercostal a. and v. 31. Longissimus dorsi m. 32. Vertebral body, T8 (middle) 33. Spinal cord, ventral columns, and spinal nerve in vertebral notch 34. Spinal cord, dorsal columns 35. Vertebral spinous process of T7	36. Semispinalis dorsi and multifidus mm. 37. Trapezius m. 38. Vertebral transverse process (T8) 39. Spinal nerve ganglion 40. Hemiazygos v. 41. Rib 8 and latissimus dorsi m. 42. Left pulmonary v. br. 43. Teres major m. 44. Lung, left lower lobe 45. Serratus anterior m. 46. Thoracodorsal nerve, a., and v. and latissimus dorsi m. 47. Lung, left lower lobe, anterior medial basal segment and thoracic aorta 48. Bronchus 49. Left vagus nerve and left pulmonary ligament	50. Lung, left upper lobe, lower division (lingular) inferior segment, and left pulmonary v. 51. Coronary sinus, pulmonary interlobar (oblique) fissure 52. Left coronary a., circumflex br. 53. Left ventricular myocardium, cardiac fossa 54. Lung, left lower lobe, superior segment, and parietal pleura 55. Mitral valve, ostium 56. Epicardium (visceral pericardium) 57. Pericardial fat, pericardial and pleural cavities 58. Intercostal mm. 59. Left ventricle, papillary m. 60. Parietal and fibrous pericardium and parietal and visceral pleura 61. Aortic cardiac outlet 62. Left coronary a., anterior descending a. br. 63. Interventricular septum 64. Transversus thoracis m. 65. Lung, left upper lobe, upper division, anterior segment, and right ventricle 66. Rib 4, costal cartilage 67. Sternum, body and anterior mediastinum

This section passes through the middle of the eighth thoracic vertebra (32), grazing the inferior vertebral notch (33) and transverse processes (38). The tip of the spinous process of T7 (35) is also seen. Ventrally, the section includes the body of the sternum (67) and its articulation (3) with the fourth rib (66) cartilage. The section cuts ribs 4 (6, 66), 5 (11), 6 (16), 7 (22), and 8 (41).

In the middle mediastinum, the right atrium (8) is seen at the entrance of the superior vena cave (14). The right inferior pulmonary vein (18) and the left inferior pulmonary vein (50) are joined to the left atrium (17). The foramen ovale (15) is seen but was found to be functionally closed (typical of about 25~ of hearts). The origin of the aorta (61) is seen

at this level, which is just inferior to the aortic (semilunar) valve.

A well defined transversus thoracis muscle (64) is seen. Teres major (43) and pectoralis major (7) and minor (9) make their last appearance at this level.

The upper and lower lobes of the left lung and the upper and lower lobes of the right lung and some bronchopulmonary segments (13, 20, 54, 65) are identified in this cut.

The nerve supply to latissimus dorsi (24, 46), the thoracodorsal nerve (23, 46); the nerve to serratus anterior (45), the long thoracic nerve (21); and the nerve supply to the intercostal muscles, the intercostal neurovascular bundle (19, 25), are seen.

The thoracic duct (29) is located slightly ventral and medial to the azygos vein (29).

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